Inside Health

A New Body Politic: Learning to Like the Way We Look

By LESLIE BERGER

Published: July 18, 2000

BALTIMORE—
After peering at an African fertility headdress, a noted Degas bronze and several oils depicting plump and rosy nymphs cavorting in veils, Girl Scout Troop 1597 from Davidsonville, Md., paused before a painting called ''The Widow'' by George Bellows and gazed at its pale, drawn subject.

The woman was old rather than young and her eyes were as intensely blue as her folded hands were bony. She was swathed in solid black and her expression was anything but coy. What did the scouts make of this haunting portrait? asked Dr. Miriam Arenberg and Dr. Beth Williams-Plunkett, psychologists, during a tour of the Baltimore Museum of Art.

''She isn't happy?'' one girl almost whispered.

''She hasn't been eating?'' another chimed in.

''She looks like she just lost a family member and is so sad she can't eat,'' suggested Alix Surber, who, like most of the girls in her troop, was 11 years old.

And so it went on a Sunday afternoon not long ago when several Girl Scout troops and more than 50 other girls and women attended a program called ''Feast, Famine and the Female Form: Exploring Body Image Through Art.''

The program, part of a national campaign to prevent eating disorders, warned its young participants about the pitfalls of excessive dieting and taught them that women's bodies need a certain amount of fat to be fertile. At one work of art after another, the recurring theme was that despite a cultural obsession with thinness, beauty comes in all shapes and sizes.

There seems to be little doubt among psychologists that women, men and even children are feeling worse than ever about the way they look, especially about their weight. Several studies in the mushrooming field of body-image research have documented growing dissatisfaction with appearance and linked it, in part, to the relentless parade of reed-thin figures in magazines, billboards, movies and sitcoms.

Even denizens of the Fiji Islands are no longer immune to slim envy, according to a recent Harvard study that showed an increase in eating disorder symptoms among teenage girls there after the introduction of western television.

What elevates the issue above mere vanity is that having a poor body image is now considered a reliable predictor of future eating disorders, including anorexia, bulimia and binge eating.

Although obesity is the greater concern numerically, anorexia is the psychiatric illness with the highest mortality rate, psychologists say.(An estimated 10 to 15 percent of all children are overweight, according to the Centers for Disease Control and Prevention; 3 percent of young women have eating disorders, the National Institute of Mental Health estimates.)

Because of the serious implications, the self-perceptions of young women have become the focus of intense research and inspired a variety of programs, like the museum tour, to challenge unhealthy ideals.

Many of the programs use names like Free to Be Me, Go Girls and Full of Ourselves, and their lessons are as politically charged as those sassy titles suggest.

''We cast eating disorders as a social justice issue and teach weightism as a form of prejudice,'' said Dr. Catherine Steiner-Adair, a clinical psychologist and director of education, prevention and outreach at the Harvard Eating Disorders Center.

Go Girls is a 12-lesson course promoting media literacy developed by Eating Disorders Awareness and Prevention, a nonprofit group in Seattle. It has been sold to dozens of high schools around the country.

It encourages girls to evaluate commercial images critically and to protest offensive messages by writing to sponsors and boycotting them. The effectiveness of the two-year-old program is being evaluated by a team of research psychologists. Its developers also sponsor the museum tour in Baltimore, which began as a yearly event and is now a regular program because of demand.

In the St. Paul area, Dr. Dianne Neumark-Sztainer, an epidemiologist, is seeking financing to expand a similar course in media advocacy, Free to Be Me, which she ran last year in a dozen Girl Scout troops.

When she compared the attitudes of the fifth- and sixth-grade scouts with those of their counterparts in a dozen other troops, Dr. Neumark-Sztainer, who teaches at the University of Minnesota's School of Public Health, found that the girls in the intervention program were less likely to obsess about being thin.

The girls, from New England and Oklahoma, were surveyed before and after a program called Full of Ourselves: Advancing Girl Power, Health and Leadership. The four-month course was taught in physical education classes, at lunch and in after-school programs. It addressed, among other topics, the natural weight gains that occur in puberty and ways to tell the difference between physical and emotional hunger.

Although the program's long-term effects remain to be seen, preliminary results show that the girls who took the course increased their self-esteem and willingness to defend victims of teasing, Dr. Steiner-Adair said.

''If we've known for years that anorexic chic is damaging to girls, why haven't we removed it?'' Dr. Steiner-Adair said. ''From my perspective, we cannot afford to wait for Hollywood and the fashion industry to take on girls' poor body image.''

But other recent research shows that blame for fat phobia can be shared. Pressure from parents and peers to be thin and to look good may be as big a culprit as the media in undermining developing body images, said Dr. J. Kevin Thompson of the University of South Florida in Tampa. And teasing -- especially by girls' fathers and older brothers -- is emerging as a powerful influence on those who feel bad about their bodies, Dr. Thompson and others said.

''Appearance is more important in our society than ever,'' said Dr. Thompson, who is studying why some people internalize a culture's thin ideals and others do not.

Body image disturbance became a subject of research about 15 years ago, within studies of eating disorders, but now is considered a psychiatric illness of its own. Many people may covet a supermodel's face and figure as they pass a magazine rack, Dr. Thompson and others acknowledged. But when they become so preoccupied with appearance that they spend more time grooming and exercising than working and seeing friends, then clearly something is wrong.

In the most extreme form of body image disturbance -- known as body dysmorphic disorder -- people become reclusive and resort to multiple plastic surgeries to correct flaws that are either imagined or exaggerated. More commonly, body image disturbance leads to depression, social anxiety and sexual dysfunction, said Dr. Thomas F. Cash, a psychologist at Old Dominion University in Norfolk, Va.

Dr. Cash, regarded as a pioneer in the field, has developed an eight-step body image improvement program that can be used with a therapist or alone. The program begins by analyzing how the problem started and how it affects the patient's daily behavior. Then it trains the patient to appreciate her body's functions and sensations more than appearance; being able to give birth and enjoy dancing, for example, have little to do with looking perfect.

Dr. Cash says he is skeptical of the array of eating disorder prevention programs that don't delve into the underlying issue of poor body image. The programs, he added, have shown mixed results.

''I would argue that just giving people information on eating disorders and its risks and consequences without actually helping people change their at-risk behaviors and beliefs is unlikely to have much impact,'' he said.

Though the museum tour in Baltimore was only an hour long, it clearly echoed Dr. Cash's emphasis on function over form. Sometimes, Dr. Williams-Plunkett and Dr. Arenberg had to persist to make their point. At the fertility headdress, for example, it took several minutes for Dr. Arenberg to train the scouts' attention on the sculpture's hard-to-miss breasts.

''They're not only large but very pendulous,'' Dr. Arenberg noted, unable to coax any comments from the embarrassed sixth grade girls.

''Pendulous means sagging,'' Dr. Williams-Plunkett added brightly. ''And what is one of the most wonderful things a woman's body can do for her?'' she pressed on. ''Having babies and feeding the babies. But anorexic women can't have children or feed them because they don't have the body fat.''

By the end of the tour, the scouts sounded like seasoned critics. Seated before Robert Colescott's huge modern painting ''At the Bathers Pool (Venus Is Still Venus),'' they noticed right away that the four African-American nudes on the canvas were focused on the only white nude. In Mr. Colescott's parody of beauty images, the icon is a thin blonde with big breasts and legs so long she towers above the other figures. The scouts quickly grasped the artist's sardonic message.

''It looks like they might be worshiping her,'' remarked Hilary Loechel, one of the scouts.

''So,'' concluded Dr. Arenberg, ''this is a very graphic way of showing whose standards of beauty dominate.''

Photos: Dr. Beth Williams-Plunkett, left, and Dr. Miriam Arenberg leading Girl Scouts on an appreciation tour of the female form at the Baltimore Museum of Art and discussing ''At the Bathers Pool'' by Robert Colescott and, below, ''Little Dancer, Aged 14'' by Degas. (Photographs by Sal DiMarco Jr. for The New York Times)